Page 214 - Hospital Authority Convention 2017

Service Enhancement Presentations
HOSPITAL AUTHORITY CONVENTION 2017

F5.6 Healthcare Advances, Research and Innovations 09:00 Room 421

The Analgesic Efficacy of Diclofenac Suppository in Parturients after Caesarean Section
Ng SW, Ho LF, Leung PH, Ng WYJ
Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong
Introduction
In the past, opioid (Pethidine) injection was used to be the foremost pain relief method for post Caesarean Section. However,
there are well documented negative side-effects, such as sedation, nausea and vomiting. In order to reduce the opioid
usage after Caesarean Section, our unit starts to give Diclofenac suppository (NSAID) in May 2016 if there is no medical
contraindication. It is believed that multi-modal pain therapy, such as combination of NSAID and opioid, could achieve
the goal of pain relief and minimise the side effects of opioid. Nevertheless, local experience on opioid-sparing effect of
Diclofenac suppository has not been reported. Therefore, a retrospective study has been conducted.

Objectives
To evaluate the analgesic efficacy of diclofenac suppository given to parturients after Caesarean Section.
Methodology
This was a retrospective study with all the medical records of parturients undergoing Caesarean Section from March to May
2016 were reviewed. Those parturients under general anaesthesia and with post-operative patient controlled analgesia (PCA)
were excluded from data analysis. This was to circumvent the potential post-anaesthetic effect that would affect opioid
injection. Analyses were performed by using SPSS (version 16.0) statistical software. Chi-square tests and one-way analysis
of variance were used to assess the relationship between various variables.
Results
Of the 154 subjects in this study, 31.8% (49/154) and 47.4% (73/154) parturients with and without Diclofenac suppository had
received opioid injection respectively. The group with Diclofenac suppository was less likely to require opioid injection than
the other group without Diclofenac suppository (p=0.001). For those who needed opioid injection, the mean interval between
the end of operation and the first opioid injection in Diclofenac group was 7.72±5.55 hours, and in non-Diclofenac group
was 5.28±4.88 hours (p=0.012). The total dosage of opioid injection given within 24 hours was less in Diclofenac group
(151.5±65.8mg) than non-Diclofenac group (190.1±98.5mg), and p value = 0.018.
Results indicated that parturients under regional anesthesia with Diclofenac suppository after Caesarean Section was
effective in opioid-sparing, and could delay the time of injection and reduce total dosage of opioid requested.

Wednesday, 17 May

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